Individual
ALYSSA BUSHONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10400 BLACKLICK EASTERN RD, PICKERINGTON, OH 43147-8235
(567) 208-7947
Mailing address
615 W DIXON ST, FOREST, OH 45843-1217
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0487170
—
OH
Enumeration date
10/18/2024
Last updated
10/18/2024
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